MRS. COLLEEN MARIE WAXLER (NPI# 1548230956) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1548230956 |
| Entity Type | Individual |
| Full Name | MRS. COLLEEN MARIE WAXLER |
| Credential | MA LPC MH LMFT |
| Practice Address |
3601 Canyon Lake Dr Chrysalis Rapid City SD 57702 |
| Mailing Address |
3601 Canyon Lake Dr Rapid City SD 57702 |
| Practice Telephone | 6053418647 |
| Practice Fax Number | 6053410489 |
| Mailing Telephone | 6053418647 |
| Mailing Fax Number | 6053410489 |
| Enumeration Date | 2006-01-26 |
| Last Update Date | 2007-07-08 |
| Gender Code | F |
| Is Sole Proprietor | X |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| X | 101Y00000X | Counselor | 2022 | SD | Behavioral Health & Social Service Providers |
| X | 106H00000X | Marriage & Family Therapist | 1080 | SD | Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| SD | 6575172 | 05 |
| Street Address |
3601 CANYON LAKE DR CHRYSALIS |
| City | RAPID CITY |
| State | SD |
| Zip Code | 57702 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881664860 | Linda K Thoreson-holcomb | Social Worker | 3601 Canyon Lake Dr, Rapid City, SD 57702 | 2006-01-24 |
| 1164606570 | Dewey J. Ertz | Counselor | 3601 Canyon Lake Dr, Rapid City, SD 57702-3900 | 2007-12-20 |
| 1972701266 | Linda Holcomb,msw, Inc | Social Worker | 3601 Canyon Lake Dr, Rapid City, SD 57702-3900 | 2007-07-07 |
| 1033255146 | William A. Moss, Psy.d., LLC | Psychologist | 3601 Canyon Lake Dr, Rapid City, SD 57702-3900 | 2007-01-29 |
| 1952314189 | Geri Cory Konenkamp | Counselor | 3601 Canyon Lake Dr, Rapid City, SD 57702-3305 | 2006-08-15 |
| 1629048483 | William A. Moss | Psychologist | 3601 Canyon Lake Dr, Rapid City, SD 57702-3305 | 2006-01-25 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366049660 | Byrne Dental, Professional LLC | Dentist | 3825 Canyon Lake Dr, Rapid City, SD 57702 | 2020-10-08 |
| 1427603026 | Mikaela Licht | Technician | 4310 Cedar Ridge Pl. Apt #5, Rapid City, SD 57702 | 2019-08-09 |
| 1932761335 | Great Plains Tribal Chairmen's Health Board | Pharmacy | Oyate Health Center, 3200 Canyon Lake Drive, Rapid City, SD 57702 | 2019-07-05 |
| 1598231334 | Regional Health Physicians, Inc. | Clinic/Center | 1635 Caregiver Circle, Rapid City, SD 57702 | 2018-10-19 |
| 1851813224 | Angie Deneire | Licensed Practical Nurse | 7312 Pinon Jay Circle, Rapid City, SD 57702 | 2017-07-07 |
| 1073063830 | Kirsten William-kennedy Dds, Ms, P.C. | Dentist | 740 Sheridan Lk. Rd. Suite A, Rapid City, SD 57702 | 2016-10-05 |
| 1932558939 | Emily T Rausch | Physical Therapist | 2040 West Main, #212, Rapid City, SD 57702 | 2016-06-09 |
| 1033597810 | John Dennis Burke | Speech-Language Pathologist | 4635 Wentworth Drive, Rapid City, SD 57702 | 2015-05-12 |
| 1013394535 | Dakota Regional Periodontics | Dentist | 2800 Jackson Blvd #6, Rapid City, SD 57702 | 2015-05-05 |
| 1306272414 | Lindsy Jo Wathen | Speech-Language Pathologist | 13232 Klondike Road, Rapid City, SD 57702 | 2013-09-20 |
| Find all providers in zip 57702 | ||||
| Taxonomy Code | 101Y00000X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master’s degree and clinical experience and supervision for licensure or certification. |
| Notes: Sources: Abridged from definitions provided by the National Board of Certified Counselors and the American Association of Pastoral Counselors. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477168821 | Rebecca L Cornell-marsich | Counselor | 1242 Tinton Ln, Rapid City, SD 57703-6536 | 2020-09-12 |
| 1609346006 | Kris Jeakins | Counselor | 1501 Centre St Ste 200, Rapid City, SD 57703-3004 | 2018-11-28 |
| 1487024972 | Peak Vitality Counseling Services, LLC | Counselor | 403 National St Ste 1, Rapid City, SD 57702-5908 | 2015-09-28 |
| 1295114700 | Ron J Scherr | Counselor | 1520 N. Haines Ave, Suite 6, Rapid City, SD 57701 | 2015-05-29 |
| 1891100079 | Nora Christina Boesem | Counselor | 529 Kansas City St Ste 100, Rapid City, SD 57701-3798 | 2014-06-25 |
| 1740604099 | Mahala Bach | Counselor | 1575 N Lacrosse St, Suite H, Rapid City, SD 57701-6976 | 2014-02-06 |
| 1881947422 | Josee Suess Carlin | Counselor | 3402 Cottonwood St, Rapid City, SD 57702-3429 | 2012-10-19 |
| 1497046387 | Stacy Lynn Keyser | Counselor | 832 Saint Joseph St Ste 204, Rapid City, SD 57701-3168 | 2011-04-26 |
| 1225338825 | Carolyn Sue Parker | Counselor | 7808 Croyle Ave, Rapid City, SD 57702-8912 | 2010-10-28 |
| 1841507142 | Horseplay Productions Healing Center, Inc. | Counselor | 1101 E. Philadelphia Street, Rapid City, SD 57701 | 2010-09-08 |
| Find all providers in RAPID CITY | ||||
| City | RAPID CITY |
| Zip Code | 57702 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.